Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus, Ohio; Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
J Surg Res. 2013 Nov;185(1):329-37. doi: 10.1016/j.jss.2013.05.064. Epub 2013 Jun 12.
Impaired gut barrier function and acute lung injury (ALI) are significant components of the multiorgan dysfunction syndrome that accompanies severe burns. Heparin-binding epidermal growth factor-like growth factor (HB-EGF) has been shown to reduce inflammation, preserve gut barrier function, and protect the lungs from acute injury in several models of intestinal injury; however, comparable effects of HB-EGF after burn injury have never been investigated. The present studies were based on the hypothesis that HB-EGF would reduce the severity of ALI and multiorgan dysfunction after scald burns in mice.
Mice were randomized to sham, burn (25% of total body surface area with full thickness dorsal scald), and burn + HB-EGF groups. The HB-EGF group was pretreated with two enteral doses of HB-EGF (1200 μg/kg/dose). Mice were resuscitated after injury and sacrificed at 8 h later. Their lungs were harvested for determination of pulmonary myeloperoxidase activity, wet:dry ratios, and terminal deoxynucleotidyl transferase dUTP nick end label and cleaved caspase 3 immunohistochemistry. Lung function was assessed using the SCIREQ Flexivent. Splenic apoptosis was quantified by Western blot for cleaved caspase 3, and intestinal permeability was measured using the everted gut sac method.
Mice subjected to scald burn injury had increased lung myeloperoxidase levels, increased pulmonary and splenic apoptosis, elevated airway resistance and bronchial reactivity, and increased intestinal permeability compared with sham mice. These abnormalities were significantly attenuated in mice that were subjected to scald burn injury but treated with enteral HB-EGF.
These data suggest that HB-EGF protects mice from ALI after scald burn and attenuates the severity of postburn multiorgan dysfunction.
受损的肠道屏障功能和急性肺损伤(ALI)是严重烧伤伴随的多器官功能障碍综合征的重要组成部分。肝素结合表皮生长因子样生长因子(HB-EGF)已被证明可减少炎症、维持肠道屏障功能,并在几种肠损伤模型中保护肺部免受急性损伤;然而,HB-EGF 在烧伤后的类似作用从未被研究过。本研究基于以下假设:HB-EGF 可减轻烫伤烧伤后小鼠的 ALI 和多器官功能障碍的严重程度。
将小鼠随机分为假手术组、烧伤组(25%的全身表面积全层背部烫伤)和烧伤+ HB-EGF 组。HB-EGF 组预先用两次肠内 HB-EGF 剂量(1200 μg/kg/剂量)处理。损伤后对小鼠进行复苏,并在 8 小时后处死。收获其肺部以测定肺髓过氧化物酶活性、湿重:干重比以及末端脱氧核苷酸转移酶 dUTP 缺口末端标记和裂解 caspase 3 免疫组化。使用 SCIREQ Flexivent 评估肺功能。通过 Western blot 定量检测脾细胞凋亡中的裂解 caspase 3,并使用外翻肠囊法测量肠通透性。
与假手术组相比,烫伤烧伤小鼠的肺髓过氧化物酶水平升高,肺和脾细胞凋亡增加,气道阻力和支气管反应性增加,肠通透性增加。与烫伤烧伤小鼠相比,接受烫伤烧伤但接受肠内 HB-EGF 治疗的小鼠的这些异常明显减轻。
这些数据表明 HB-EGF 可保护烫伤烧伤后的小鼠免于 ALI,并减轻烧伤后多器官功能障碍的严重程度。